芦山地震医疗救援的医院感染监测与预防
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摘要
目的通过采取有效措施,降低地震受伤患者发生医院感染的风险及医院感染发生率,提高救治成功率。方法 2013年4月20日医院收治了大量的地震受伤患者,医院感染管理科采取前瞻性监测方法进行监测,每日进行医院感染的主动筛查;同时为了解汶川地震医院感染发生情况,用随机的方法抽取2008年5月12日汶川地震受伤患者中10%的病历即190份病历资料进行医院感染回顾性调查,将目标性监测结果与汶川地震比较,检验感染控制措施的有效性。结果截止2013年5月2日共收治芦山地震受伤患者319例,发生医院感染11例,感染率为3.45%;随机抽样调查汶川地震受伤患者190例,发生医院感染14例,感染率7.37%;芦山地震受伤患者中发生下呼吸道感染4例,感染率为1.25%,汶川地震受伤患者中发生下呼吸道感染6例,感染率为3.16%,两者比较差异均有统计学意义(P<0.05)。结论发生地震等公共卫生突发事件后,感染控制人员应及早介入,制定、下发、督导临床执行医院感染预防控制措施,并深入参与临床工作,发现医院感染高风险的患者采取个性化的感染控制措施,最大限度地降低发生医院感染的风险及医院感染发生率,保障患者的安全。
OBJECTIVE To reduce risk and incidence of nosocomial infections in the earthquake victims through effective measures so as to improve the success rate of rescue.METHODS A large number of earthquake victims were treated in the hospital from May 12,2008to Apr 20,2013,the prospective surveillance was conduced by the infection control department,and the daily active screening of the cases of nosocomial infections was performed;meanwhile the incidence of nosocomial infections in Wenchuan earthquake was investigated;in a randomized trial,10% of the victims of Wenchuan earthquake(190cases)were investigated,then the result of targeted surveillance was compared with that of the Wenchuan earthquake,and the effectiveness of the infection control measures was determined.RESULTS By the time of May 2,2013,totally 319Lushan earthquake victims have been treated,among which the nosocomial infections occurred in 11(3.45%)cases;the randomized survey showed that among 190cases of Wenchuan earthquake victims,the nosocomial infections occurred in 14(7.37%)cases;there were 4(1.25%)cases of lower respiratory tract infections among the Lushan earthquake victims and 6(3.16%) cases among the Wenchuan earthquake victims,the difference between the two was significant(P<0.05).CONCLUSIONIn the outbreak of such public health incidents as the earthquake,it is necessary for the infection control personnel to interfere immediately to formulate and issue the prevention measures and supervise the implementation,to deeply involve the clinical work,to find the patients at high risk of nosocomial infections and take personalized infection control measures,and to minimize the risk of nosocomial infections so as to ensure the safety of the patients.
OBJECTIVE To reduce risk and incidence of nosocomial infections in the earthquake victims through effective measures so as to improve the success rate of rescue.METHODS A large number of earthquake victims were treated in the hospital from May 12,2008to Apr 20,2013,the prospective surveillance was conduced by the infection control department,and the daily active screening of the cases of nosocomial infections was performed;meanwhile the incidence of nosocomial infections in Wenchuan earthquake was investigated;in a randomized trial,10% of the victims of Wenchuan earthquake(190cases)were investigated,then the result of targeted surveillance was compared with that of the Wenchuan earthquake,and the effectiveness of the infection control measures was determined.RESULTS By the time of May 2,2013,totally 319Lushan earthquake victims have been treated,among which the nosocomial infections occurred in 11(3.45%)cases;the randomized survey showed that among 190cases of Wenchuan earthquake victims,the nosocomial infections occurred in 14(7.37%)cases;there were 4(1.25%)cases of lower respiratory tract infections among the Lushan earthquake victims and 6(3.16%) cases among the Wenchuan earthquake victims,the difference between the two was significant(P<0.05).CONCLUSIONIn the outbreak of such public health incidents as the earthquake,it is necessary for the infection control personnel to interfere immediately to formulate and issue the prevention measures and supervise the implementation,to deeply involve the clinical work,to find the patients at high risk of nosocomial infections and take personalized infection control measures,and to minimize the risk of nosocomial infections so as to ensure the safety of the patients.
引文
[1]KevenK,Ates K,MS,et al.Infectious complications after massdisasters:the marmara earthquake experience[J].Scand J InfectDis,2003,35(2):110-113.
[2]OnculO,keskinO,AcarHV,et al.Hosiptal-acquired infectionsfollowing the 1999 Marmara earthquake[J].J Hosp Infect,2002,51(1):47-51.
[3]Uckay I,Sax H,HarbarthS,et al.Multi-resistant infections inrepatriated patients after natural disasters:lessons learnedfrom the 2004tsunami for hospital infection control[J].JHosp Infect,2008,68(1):1-8.
[4]尹维佳,谭成,曾智,等.汶川地震医疗救援中华西医院急诊预检分诊的管理[J].中国循证医学杂志,2008,8(8):623-624.
[5]乔甫,谭成,曾智,等.汶川地震医疗救援中华西医院急诊预检分诊的管理[J].中国循证医学杂志,2008,8(12):1136-1137.
[2]OnculO,keskinO,AcarHV,et al.Hosiptal-acquired infectionsfollowing the 1999 Marmara earthquake[J].J Hosp Infect,2002,51(1):47-51.
[3]Uckay I,Sax H,HarbarthS,et al.Multi-resistant infections inrepatriated patients after natural disasters:lessons learnedfrom the 2004tsunami for hospital infection control[J].JHosp Infect,2008,68(1):1-8.
[4]尹维佳,谭成,曾智,等.汶川地震医疗救援中华西医院急诊预检分诊的管理[J].中国循证医学杂志,2008,8(8):623-624.
[5]乔甫,谭成,曾智,等.汶川地震医疗救援中华西医院急诊预检分诊的管理[J].中国循证医学杂志,2008,8(12):1136-1137.
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